Individual
JOHN VAN MANEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1804 S PERKINS RD, STILLWATER, OK 74074-7939
(405) 624-3671
(405) 624-1020
Mailing address
1804 S PERKINS RD, STILLWATER, OK 74074-7939
(405) 624-3671
(405) 624-1020
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
01/03/2012
Last updated
01/03/2012
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